Acute respiratory distress syndrome and septic cardiomyopathy. Successful application of veno-venoarterial extracorporeal membrane oxygenation

作者：Kuestermann J; Gehrmann A; Kredel M; Wurmb T; Roewer N; Muellenbach R M^*

来源：Anaesthesist, Der, 2013, 62(8): 639-643.

DOI：10.1007/s00101-013-2213-7

• Ventilation
• Artificial lung
• Heart failure
• Septic shock
• Cardiomyopathies

A 30-year-old patient was admitted to hospital with fever and respiratory insufficiency due to community acquired pneumonia. Within a few days the patient developed septic cardiomyopathy and severe acute respiratory distress syndrome (ARDS) which deteriorated under conventional mechanical ventilation. Peripheral venoarterial extracorporeal membrane oxygenation (va-ECMO) was initiated by the retrieval team of an ARDS/ECMO centre at a p(a)O(2)/FIO2 ratio of 73 mmHg and a left ventricular ejection fraction (EF) of 10 %. After 12 h va-ECMO was converted to veno-venoarterial ECMO (vva-ECMO) for improvement of pulmonary and systemic oxygenation. Left ventricular function improved (EF 45 %) 36 h after starting ECMO and the patient was weaned from vva-ECMO and converted to vv-ECMO. The patient was weaned successfully from vv-ECMO after 5 additional days and transferred back to the referring hospital for weaning from the ventilator.

• 出版日期2013-8